Termination of acute wide QRS complex atrial fibrillation with ibutilide

Ibutilide is a Vaughan-Williams class III antiarrhythmic agent approved for chemical cardioversion of acute onset atrial fibrillation/flutter. Emergen cy physicians rarely use ibutilide despite its proven clinical value. We re port a case at successful chemical cardioversion using ibutilide in a patie nt with atrial fibrillation and delayed ventricular depolarization (wide QR S complex). We recommend that ibutilide be considered far wider use in the emergency department and that further studies be conducted.